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1 When you have cancer, your body needs more calories and protein. Eating challenges such as difficulty swallowing, loss of appetite, nausea, diarrhea, and fatigue make it difficult to eat enough calories and protein. The key is to make every bite count by eating high protein and high calorie foods. Follow these tips to help increase calorie and protein intake: Eat small, frequent meals instead of 3 large meals. o Eat at least 5-6 small meals or snacks per day. o Eat every 2 to 3 hours even if you do not feel hungry. o Set a timer to remind you it is time to eat. Eat the most when you feel hungriest. o Eat protein foods like chicken, fish, meat, eggs, nuts, and beans first. Use smoothies and shakes to get in calories and protein. o Liquids can be easier to consume than solid foods. o Smoothies or shakes can serve as a small meal replacement. o Add ingredients such as whole milk, powdered milk, protein powder, peanut butter, ice cream, or yogurt to smoothies or shakes to add calories and protein. o Premade liquid nutrition supplements are available at grocery and drug stores. Ask a registered dietitian which type is best for you. o Ingredients such as whole milk, peanut butter, ice cream, yogurt, or fruit can be added to liquid nutrition supplements. Add more fats to foods to increase the calories. o Fat has more calories per gram than carbohydrates or protein. o Use butter, oils, mayonnaise, sour cream, and salad dressings liberally. o When cooking, use oil or butter instead of a nonstick spray.

2 o Add mayonnaise to sandwiches and tuna or chicken salad. o Add peanut butter or cream cheese to toast or crackers. Drink most liquids between meals instead of with meals. o Drinking liquids such as water, juice, or soda while you eat can make you feel full faster. o Drink only small amounts with meals. o Drink higher calorie liquids like juice and milk between meals. o Drink smoothies, shakes, and liquid nutrition supplements with a meal or in place of a meal. Snack regularly throughout the day. o Keep quick and easy snacks with you. o Try granola bars, trail mix, peanut butter crackers, nuts, and dried fruit. o Keep your favorite snacks around so you will eat more. o Eat a bedtime snack. It will not affect your appetite at your next meal. o Peanut butter crackers, half a sandwich, yogurt, and cereal are good bedtime snacks.

3 Power Foods to Include In Your Meals and Snacks: Food Provides Ways to Incorporate It Into Your Diet Cheese Add to casseroles, soups, mashed potatoes, sandwiches, vegetables, eggs, and meats. Cottage Cheese and Ricotta Cheese Add it to Italian dishes, casseroles, and eggs Milk Use whole milk instead of low fat or skim milk. Use milk instead of water for cocoa, hot cereal, and soups. Nonfat Instant Dry Milk Powder Ice Cream, Yogurt, and Frozen Yogurt Put it in casseroles, meatloaf, baked goods, soups, mashed potatoes, macaroni and cheese, puddings, and custards. Add to liquid nutrition supplements or mix with fruit. Make a sundae or parfait using either yogurt, granola, and fruit or ice cream, nuts, and chocolate syrup. Eggs Add chopped hard-boiled eggs to salads, vegetables, and casseroles. Add to custards, puddings, quiches, and omelets. (Make sure you thoroughly cook any dish you add raw eggs to). Nuts, Seeds, and Wheat Germ Add to casseroles, breads, muffins, pancakes, cookies, and waffles. Sprinkle on fruit, cereal, ice cream, yogurt, vegetables, salads, and toast. Use instead of breadcrumbs in recipes.

4 Food Provides Ways to Incorporate It Into Your Diet Spread on sandwiches, toast, muffins, crackers, waffles, pancakes, and fruit such as apples and bananas. Use as a dip for raw vegetables. Blend with liquid nutrition supplements and ice cream to make a high calorie, high protein milkshake. Swirl through soft ice cream and yogurt. Add to oatmeal to boost the protein content. Peanut Butter and Other Nut Butters Meat, Poultry, and Fish Add chopped, cooked meat, poultry, and fish to vegetables, salads, casseroles, soups, sauces, biscuit dough, omelets, soufflés, quiches, sandwich fillings, chicken and turkey stuffings. Wrap in pie crust or biscuit dough as turnovers, add to stuffed baked potatoes. Beans, Legumes, and Tofu Add to casseroles, pasta, soup, salad, and grain dishes. Mash cooked beans with cheese and milk. Use beans, tahini, and olive oil to make a tasty hummus spread. Granola Calories Use in muffin, and bread batters. Sprinkle on vegetables, yogurt, pudding, custard, fruit. Make your own trail mix by combining dried fruits and nuts.

5 Food Provides Ways to Incorporate It Into Your Diet Dried Fruits (Raisins, Prunes, Apricots, Dates, and Figs) Calories Add to oatmeal for a sweet treat or add to homemade muffins, cookies, and breads. Put them in cakes, rice and grain dishes, cold cereal, puddings, stuffings, cooked vegetables, pies and turnovers or mix with granola and nuts for your own trail mix. *Power foods list adapted from: National Cancer Institute. Eating Hints Before, During, and After Cancer Treatment